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Published Wednesday, August 19, 2009 in Local

Options suggested for state in health reform process

By Winston Skinner

The Times-Herald

The Georgia Healthcare Freedom Act has a Web site, a Facebook page and some bright red cards that were distributed -- along with other materials -- at the Health Care Town Hall held Monday night at the Coweta County Fairgrounds.

The GHFA is the brainchild of Gerry Purcell, a national medical insurance expert who is also a veteran and a cancer survivor. Purcell, who is running for Georgia insurance commission in 2010, was one of the panelists at the forum sponsored by the Southern Crescent Tea Party Patriots.

Purcell wants the GHFA to be a referendum on the ballot in Georgia. The petition reads: "We, the citizens of the state of Georgia, believe that all people should have the right to make decisions about their health care, and thus no law shall be passed that restricts a person's freedom to choose a private health care system or private plan of any type. No law shall interfere with a person's or entity's right to pay directly for lawful medical services, nor shall any law impose a penalty or fine, of any type, for choosing to obtain or decline health care coverage or for participation in any particular health care system or plan."

Purcell's proposal clearly is aimed as a "particular health care system or plan" -- the proposal by the Obama administration to create a public option program that would be a government-run alternative to private health insurance.

The Obama plan would provide health coverage to the currently uninsured. Estimates for that number range widely -- from about 15 million to more than 45 million.

Purcell said three days after he was diagnosed with cancer he was in surgery. His doctor gave him two options -- a more invasive procedure with a 93.3 percent success rate and a less invasive one with an 89.9 percent rate. He chose the second option, said it was the right one for him and said he believes no one -- other than himself, his family and his doctor -- should have been involved in that decision.

Purcell said the doctor-patient relationship was relatively simply until the emergence of health insurance in the 1940s. The creation of Health Maintenance Organizations in 1973 "was the worst decision we made in health care," he said, adding layers of bureaucracy to medical treatment.

Purcell said there are several keys to cutting costs and meeting the medical needs of people. One needed change is transparency in what medical procedures cost. "We have more information about buying a washer and dryer than we do about health care," he said.

He noted there is a 4.75 percent tax on insurance premiums in Georgia. That cost is hidden from consumers, who pay it without ever knowing it exists. "None of that tax is going back to health care," Purcell said.

Purcell said consumers should be able to purchase insurance products across state lines -- noting costs for the same policy may vary greatly across the country. "It would level the playing field overnight," he said.

Purcell also said providing incentives for companies to have on-site clinics would be a good plan. Also, incentives for hospitals to maintain 24-hour clinics next to their emergency rooms would net $50 office visit rather than more expensive emergency bills for minor illnesses and injuries.

Purcell said there is $100 billion a year in fraud that becomes part of the American health care expense. Another $100 billion is spent by doctors on legal liability coverage. Purcell said having more investigators to track down fraud would be wise.

Other states -- Oklahoma, Tennessee, Texas -- are looking at innovations to improve health care for their residents. Georgia should study those practices, Purcell said.

Another panelist, Ron Bachman, senior fellow with the Center for Health Care Transformation, said Georgia is already doing some good things. He said Georgia is the only state so far that allows insurers to offer a specific type policy that will reward people who incur low medical costs.

"You get money back for doing the right thing," he said. He said officials in Missouri and South Carolina are looking at the Georgia law and its implications.

Bachman quoted Newt Gingrich, one of the founders of the CHCT: "Legislation tends to crowd out the future."

He said legislated health policy often gets frozen in an outdated paradigm. For example, he noted Medicare recipients have separate A and B policies for hospitalization and physician care. That model was popular with large insurance companies in the 1960s when the program was created, but has been superseded by comprehensive policies in the private sector.

"It's like you have to go out and drive a 1964 Chevrolet with no air conditioning, no CD player, no heated seats," Bachman said.

In response to an audience question, Bachman agreed there are questions about whether the federal government legally can get involved in running the nation's health care system. He noted the provision in the Constitution that leaves powers not enumerated in the Constitution to the states.

For several decades, the government has been involved with medical care -- Medicare, Medicaid -- and education, another area not listed among the federal government's constitutional powers. Bachman said the federal government has generally held sway by refusing to release money to states that did not go along with federal rulings.

"They've been pretty compliant," Bachman said of the states. He said a suit could be filed against the federal government to block or challenge a nationwide health program.

"We don't need the federal government to come in," Bachman said.

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